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FIG 1. Case 2: 32-year-old HIV-positive woman with PML and survival time exceeding 22 months.
A and B, Initial MR study, December 1998. Axial FLAIR-FSE (TR/TE = 10000/150, TI = 2600) image (A) shows high-signal-intensity lesion in the white matter of the right centrum semiovale (arrow). There is no mass effect. No enhancement was present on contrast-enhanced T1-weighted (550/20) image (B).
C and D, Follow-up MR study, January 1999 (1 month after initiation of HAART). FLAIR-FSE (10000/150, TI = 2600) image (C) shows progression of white matter abnormalities (arrow) with mass effect and compression of right ventricle. Increased hypoattenuation of the lesion was evident on T1-weighted (550/20) images (not shown). On contrast-enhanced T1-weighted (550/20) image (D), diffuse enhancement of white matter abnormalities is present (arrows).
E and F, Subsequent MR study, February 1999 (2 months after initiation of HAART). FLAIR-FSE (10000/150, TI = 2600) image (E) shows further progression of the high-signal-intensity lesions of white matter disease (asterisks). Slight enhancement is still present on contrast-enhanced T1-weighted (550/20) image (F). Note increased hypoattenuation of the lesions and regression of the mass effect. Continued on page 982
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